Mechanical Dyssynchrony in Congestive Heart FailureDiagnostic and Therapeutic Implications
Sherif F. Nagueh, MD1,*
The Methodist DeBakey Heart Center, The Methodist Hospital, Houston, Texas.
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Figure 1 Examples of Dyssynchrony and Dyssynergy
(Left) An example of dyssynchrony from a patient with depressed ejection fraction. Lateral systolic velocity (blue) occurs 76 ms after septal systolic velocity (yellow). (Right) An example of dyssynergy. Notice the simultaneous occurrence of peak systolic velocities in these 2 opposite walls, despite a notable difference in the velocity amplitude. In both panels, yellow arrows indicate time intervals to peak systolic velocities.
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Figure 2 Systolic Dyssynchrony and Mitral Annulus Velocities From a Patient With Heart Failure and Normal EF
(Top) An example of systolic dyssynchrony from a patient with heart failure and normal ejection fraction (EF). Posterolateral systolic velocity (yellow) occurs 110 ms after anteroseptal systolic velocity (blue). (Lower left) Myocardial velocities at septal annulus. (Lower right) Myocardial velocities at lateral annulus. Notice the reduced systolic (Sa) and early diastolic (Ea) velocities and the markedly reduced Ea/Aa ratio at both sites. Aa = myocardial late diastolic velocity.
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